Pharmacology MSN 571 practice questions|A+ Graded

Pharmacology MSN 571 practice questions|A+ Graded A patient diagnosed with chronic pain calls to request an oxycodone (Oxycontin) refill. Which action should the prescriber take initially? Arrange to schedule an appointment with the patient. A metered-dose albuterol inhaler is prescribed for asthma management. The patient reports feeling jittery sometimes when taking the medication, and does not feel that the medication is always effective. Which action will the provider take to best minimize patient risks and maximize medication effectiveness? Auscultate the patient's lung sounds and obtain other relevant vital signs. A patient is prescribed metronidazole for bacterial vaginosis. Which patient history finding would be most concerning to the provider? The patient drinks two glasses of wine every night. The provider prepares a patient with newly diagnosed type 1 diabetes for hospital discharge. Which action by the provider will best support the patient's ability to effectively manage medication therapy? Asking the patient to demonstrate how to measure and administer insulin A patient reports that a medication prescribed for recurrent migraine headaches is not working. Which action is the prescriber's priority when addressing the patient's concern? Ask the patient about the number and frequency of tablets taken. .The drug manual states that older adult patients are at increased risk for hepatotoxicity. Which action is most important when prescribing this medication to an 80-year-old patient? Obtaining baseline liver function studies A patient with bipolar disorder is prescribed daily lithium. Which action is most important for the provider to take in order to determine if the therapeutic level is maintained? Order periodic laboratory testing. .Which factor best supports an increase for full prescriptive authority for both advanced practice registered nurses (APRNs) and physician assistants (PAs)? More patients will have access to health care. .A pediatric patient prescribed ampicillin for streptococcal pharyngitis reports new onset of a pruritic, dull red, maculopapular rash on the chest and neck. Which action is most important for the provider to take to minimize this patient's risk for injury? Discontinue the ampicillin. .Which prescriber action will have the greatest impact on the patient's commitment to adherence to any type of medication therapy? Providing medication education that the patient can easily understand .Which patient statement suggests to the provider that the patient's nonadherence with their medication plan is related to dissatisfaction with the therapy? "I've been taking this medication for well over a week and I lost only a half a pound." .How can the prescriber's regular collaboration with a pharmacist improve positive outcomes for patients? Pharmacists have additional information on drug interactions. The pharmacist can suggest adequate medication dosing. Pharmacists have firsthand knowledge of the facility formulary. .Which statements made by the prescriber demonstrate an understanding of effective medication education? "This medication needs to be stored in the refrigerator. "Take 3 tablets daily: 1 with breakfast, 1 with lunch, and one with dinner." "You need to take the medication as we discussed until all the tablets are gone." "Call the office immediately if you begin experiencing any itching, headache, or difficulty breathing." The patient who has been prescribed lithium for a diagnosis of bipolar disorder asks why blood tests are required on a regular basis. Which provider responses demonstrate an understanding of why the patient requires a variety of laboratory tests? "We need to monitor how your thyroid is functioning." "We need to monitor kidney function while you are on this drug. This medication can cause you to lose sodium, so we need to measure sodium levels." When prescribing lovastatin, what will a provider advise to decrease the risk of developing muscle toxicity? Substitute grapefruit juice with orange juice .When prescribing drugs with a narrow therapeutic index, what intervention does the provider take to decrease risk to the patient? Monitor the patient's plasma drug levels at regular intervals. .A patient reports that a medication no longer effectively alleviates symptoms. What process informs the provider's response to the patient's concerns? Desensitization of receptor sites results from continual exposure to the drug. .A patient reports that Brand X tablets work faster than Brand Y tablets of the same amount of the same drug. Which statement informs the prescriber's response when explaining this phenomenon to the patient? Inactive ingredients used in composition can result in differing rates of dissolution, which can alter the drug's onset of action. .A patient receiving intravenous gentamicin has a toxic serum drug level. The prescriber confirms that the dosing is correct. Which possible cause of this situation will the provider explore? Whether patient is taking a medication that binds to serum albumin. .A patient takes a drug that is metabolized by CYP3A4 isoenzymes. If a CYP3A4 inducing drug is prescribed, what drug adjustment may be necessary to maintain a therapeutic level of CYP3A4 substrate? Increase dosage of the CYP3A4 substrate .The provider prescribes hydrocodone with acetaminophen for a patient's postsurgical pain. What instruction will the prescriber include regarding alcohol intake? "You should avoid drinking alcohol while you are taking the pain medication I've ordered." .Which order for furosemide is written appropriately by the prescriber? Furosemide [Lasix] 20 mg PO daily A drug can cause symptoms that resemble those of Parkinson disease. What action should the prescriber take to minimize the potential patient risk? Thoroughly educate the patient about recognizing such symptoms and the need to notify the office immediately. .A patient who has been taking sertraline for depression was prescribed azithromycin to treat an infection by a provider at an after-hours clinic. What action will the primary care provider take to address the risk this combination of medication has posed for the patient? Discontinue the azithromycin and write an order for an alternative antibiotic. A patient reports mild nausea within an hour after taking the first two doses of a newly approved medication. Nausea is not listed among the known side effects of this drug. What instructions will the provider give the patient? "Take the next dose with food and call the office if the nausea reoccurs or if other symptoms develop." .A patient develops shortness of breath shortly after taking the initial dose of a newly prescribed medication. The patient's heart rate is 86 beats/minute, the respiratory rate is 24 breaths/minute, and the blood pressure is 120/70 mm Hg. The prescriber will discontinue the drug based on the assumption the patient experienced what medication induced effect? A side effect .A provider recommends genetic testing of a patient before prescribing a medication. What response should the provider give when asked by the patient about the purpose of genetic testing? "Such testing will tell us how quickly your body is likely to metabolize, or process, the drug." .A patient is prescribed digoxin. Which screening will the provider order to monitor for potential adverse effects from this drug? Serum electrolytes .A provider considers prescribing tamoxifen for a woman with breast cancer. Upon reviewing results of genetic testing, the prescriber notes that the patient has variations in the CYP2Dy allele resulting in a deficiency of the CYP2D6 isoenzymes. What action will this deficiency warrant in the prescribing of tamoxifen, a CYP2D6 substrate? The tamoxifen will not be prescribed. A patient has taken a narcotic analgesic for chronic pain for several months. At a follow-up appointment, the provider notes that the patient has been taking more than the prescribed dosage. The patient has normal vital signs, is awake and alert, and reports mild pain. What does the provider suspect is responsible for the patient's response? This patient has developed pharmacodynamic tolerance, which has increased the minimal effective concentration (MEC) needed for analgesic effect Which patient ethnic ancestry creates a risk factor that may result in minimal beneficial response to tamoxifen therapy? French .Before initiating cetuximab therapy, the provider will order epidermal growth factor receptor (EGFR) testing for the patient having which condition? Colorectal cancer .When considering the benefit of pharmacogenomics, what information should the prescriber include when prescribing a new medication? Provide definitions and possible examples of related idiosyncratic responses to this medication .1. A provider has prescribed a female patient a medication that induces P-glycoprotein (PGP). The provider will be particularly concerned about which aspects of the patient's medical history? Intestinal problems, Kidney function, Liver function When prescribing medications to infants, it is important for the provider to consider which fact? Breast-feeding infants are more likely to develop toxicity when the mother is taking lipid-soluble drugs, Immaturity of renal function in infancy causes infants to excrete drugs less efficiently. Infants have immature livers, which slows drug metabolism, Infants are more sensitive to medications that act on the central nervous system (CNS). What will the provider consider when prescribing two drugs that compete for plasma albumin receptor sites? Binding of one or both agents will be reduced, Plasma levels of free drug will rise, Plasma levels of free drug will fall .Which actions occur in most of the fatal medication errors? Giving a drug intravenously instead of intramuscularly, Administering a drug that sounds like the prescribed drug, Writing a prescription illegibly A patient is found to have a genetic deficiency in the biomarker CYP2C19. The provider recognizes that prescribing clopidogrel will increase the patient's risk for developing what serious conditions? Myocardial infarction, Stroke .A provider speaking to a class or a group of pregnant patients correctly teaches that the highest risk of teratogen-induced gross malformations exists during which time period During the first trimester .A pregnant patient asks her provider about the safe use of medications during the third trimester. What will the provider tell her about drugs taken at this stage? "They may need to be given in higher doses if they undergo renal clearance."